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目的比较胰岛素治疗与单纯口服降糖药物治疗对老年2型糖尿病(T2DM)患者抑郁情绪的影响。方法选择2014—2015年成都军区总医院老年病区住院治疗的240例年龄≥60岁的T2DM患者作为研究对象,按照治疗方案分为胰岛素治疗组和单纯口服降糖药物治疗组,采用抑郁自评量表(CES-D)对患者的抑郁情况进行调查,并采用多因素Logistic回归模型分析胰岛素治疗对患者抑郁情绪的影响。结果胰岛素治疗组相对于单纯口服降糖药物治疗组患者的年龄更大、病程更长、并发症更多且伴发高血压的比例更高(均P<0.05)。胰岛素治疗组患者的抑郁评分为(23.89±6.72)分,高于单纯口服降糖药物治疗组的(21.08±6.13)分;胰岛素治疗组中抑郁检出率为35.00%,高于单纯口服降糖药物治疗组的20.00%(均P<0.05)。多因素Logistic回归分析显示,以单纯口服降糖药物组作为参照,在校正混杂因素前后胰岛素治疗均是老年T2DM患者发生抑郁的危险因素(校正后OR=3.374,95%CI:2.319~6.535)。结论老年T2DM患者多数存在抑郁症状,在胰岛素治疗的同时,应加强心理干预。
Objective To compare the effects of insulin therapy and oral hypoglycemic agents on depression in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 240 T2DM patients aged 60 years or older hospitalized in Chengdu Military Region General Hospital Geriatric ward from 2014 to 2015 were selected as study subjects and divided into insulin treatment group and oral hypoglycemic drug treatment group according to the treatment plan. The scale of depression (CES-D) was investigated in patients with depression, and multivariate logistic regression model was used to analyze the effect of insulin therapy on depression. Results Patients in the insulin treatment group were older, longer in duration, had more complications, and had higher rates of hypertension associated with oral glucose-lowering drug therapy alone (all P <0.05). The depression score of insulin treatment group was (23.89 ± 6.72) points higher than that of the oral hypoglycemic drug treatment group (21.08 ± 6.13) points, and the depression rate of the insulin treatment group was 35.00%, higher than that of the simple oral hypoglycemic Drug treatment group 20.00% (all P <0.05). Multivariate logistic regression analysis showed that insulin therapy was a risk factor for depression in elderly patients with T2DM (adjusted OR = 3.374, 95% CI: 2.319-6.535) before and after the correction of confounding factors. Conclusion Most elderly patients with T2DM have depressive symptoms. Psychological intervention should be strengthened at the same time as insulin therapy.